Abstract
Fibrillatory waves of 500 patients were analysed according to the method described by Peter.
In the majority of patients (73%) with rheumatic valvular disease, the amplitude of f-waves was 2.0 mm or more, whereas, in the majority of patients (84%) with non-rheu-matic heart disease, it was less than 2.0 mm.
When the patients recovered from congestive heart failure, f-waves tended to be smaller than before.
In serious rheumatic patients with high mean pulmonary cabillary pressure, f-waves were rather small although certain numbers of exceptions were present.
After cardiac surgery, the amplitude of f-waves was much decreased. When observed more than ten years, the amplitude of f-waves changed from time to time and tended to be smaller after certain period of time. The majority of patients with very fine f-waves were those of chronically ill serious condition with massive cardiomegaly.
It should be noted that large f-waves were occasionally seen in non-rheumatic patients.
Histological findings of the left atrium of chronically ill grave patients with rheumatic valvular disease were muscular hypertrophy and degeneration, interstitial fibrosis and endocardial thickening in high degree, whereas, in patients with less severe degree, the abnormalities were relatively mild. In arteriosclerotic patients, capillary sclerosis was the prominent feature and the above-mentioned findings were mild.
In conclusion, it is suggested that the atrial wave size is determined by pathological abnormalities of the atrial tissue and influenced by circulatory pathophysiological conditions of the patients, especially, strain or tension of the atrium.
